| NPI | 1114341724 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NJ 25MP00329900) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: PA MA056728) |
| Enumeration Date | 2014-02-18 |
| Last Update Date | 2020-01-10 |